Text 1 Dental fluorosis

Too much fluoride at an early age can cause a child’s adult teeth (which form
underneath their baby teeth) to stain. This is called dental fluorosis. Dental fluorosis
looks like fine, pearly-white mottling, flecking or lines on the surface of the teeth; it is
usually very hard to see. It cannot develop after teeth are fully formed and does not
affect the function of the teeth. Dental fluorosis can occur in areas with or without
water fluoridation.

Young children, aged 0 to five years, should not use full strength fluoride toothpaste if
the drinking water supply is fluoridated. Avoid any use of fluoride supplements in the
form of drops or tablets to be chewed or swallowed.

If fluoride is not the cause of staining of the teeth, it is not called dental fluorosis.
Mottling of the teeth may be caused by other things like:
 Injury to the teeth
 Certain medications
 Childhood infections.

Text 2 Fluoridation in Australia

Fluoridation was first introduced in Australia in Tasmania in 1953,

and by 1977, approximately two thirds of the Australian
population’s drinking water had been fluoridated, with studies
finding a consistently lower prevalence of dental caries among
fluoridated populations.(Armfielf 2005) .

That number has remained fairly constant to this day, though the
majority of areas receiving fluoridated water are urban populations,
with most non-fluoridated communities being in rural locations.
(Spencer et al 1996) The major exception of course is Brisbane,
which is the only major city to reject water fluoridation, and
consequently has a higher prevalence of caries than nearby
fluoridated Townsville. ( McEniery & Davies 1979, Slade et al 1996)

In areas where fluoridation occurs, continuous to weekly

assessments must be carried out in order to assure concentrations
remain within acceptable limits, (which are lower among hotter
areas to take greater fluid consumption into account) as
concentrations in excess of 1.5ppm can cause dental fluorosis
(staining of the teeth) whilst concentrations over 4ppm can cause
skeletal fluorosis. (NHMRC 2004)
Text 3 Fluoride Facts

Fluoride is a mineral found in food, water, plants and toothpaste.

Brushing with fluoride toothpaste and drinking fluoridated water helps to
protect teeth against decay. Fluoride is important for strong teeth and is
considered safe when consumed at recommended levels in drinking
water. Water fluoridation is recommended by leading national and
international health organisations.

Text 4 Abstract Matthew Scott Hopcraft and Michael Vivian Morgan

School of Dental Science, The University of Melbourne, Australia

Objectives: The purpose of this study was to investigate a group of young

Australian adults to determine their caries experience and measure
associations between caries experience and age, gender, socioeconomic
status, education level and lifetime exposure to fluoridated water.

Methods: This was achieved through a cross-sectional study involving

Australian Army recruits seen for their initial dental examination on enlistment
into the Australian Army. A total of 499 recruits had a clinical examination with
the aid of bitewing radiographs and an orthopantomograph (OPG).
Sociodemographic and fluoride exposure data were obtained via a
questionnaire.

Results: This study showed that subjects with a lifetime exposure to

fluoridated water reported a 23% lower level of caries experience than
subjects with no exposure to fluoridated water, with a greater effect on
proximal surfaces compared to smooth and occlusal surfaces. Female
subjects had a level of caries experience 25% higher than male subjects,
while subjects from the lowest socioeconomic background had a level of
caries experience 89% greater than subjects from the highest socioeconomic
group.

Conclusions: Although it is not possible to directly establish a causal

relationship from a cross-sectional study such as this, the results from this
study show a dose–response relationship which suggests that there are
benefits of lifetime exposure to fluoridated drinking water through young
adulthood.
Reading – Subtest A Level III (four texts)
Fluoride and Dental Care

Complete the following summary using the

information in the texts provided. You do
not need to read each text from beginning to
end to complete the task. You should scan
the texts to find the information you need.
Gaps may require 1, 2 or 3 words. You
should write your answers next to the
appropriate number in the right hand
column. Use correct grammar and spelling –
marks will be lost if there is incorrect
spelling. Please write legibly.

Summary Task

10

11

12

13

Fluoride is (1) found in nature, and is artificially (2) toothpaste and water to
prevent dental decay. The adding of fluoride to (3) water, and the use of
fluoride in toothpaste, is now widely recommended by national and (4) health
organisations. In a study at the (5) dental science at the University of
Melbourne, Australian (6) recruits were examined for levels of (7), using
technologies such as (8) radiography and (9). It was found that having a
lifetime (10) to fluoridated water led to a (11) reduction in caries experience,
compared (12) those without such exposure. Interestingly, females had a
slightly (13) of caries experience than males.

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28
Controversy has always (14) the subject of water fluoridation, and in Australia,
(15) all cities have (16) water. But in the areas that do have fluoridation, the
rate of dental decay is significantly (17). One of the major issues is the risk
(18). This is a condition where the teeth develop fine, (19) mottling, flecking or
lines on the (20) the teeth, due to excess exposure to fluoride. This staining,
(21) to see with the naked eye, occurs while the teeth are (22), and is
prevented by the careful use of (23) in water and toothpaste. In a city water
(24), the level of fluoride in the water should be definitely less than (25),
above which level fluorosis can occur. And (26) should not use full strength
fluoride (27) if the water is fluoridated, and should not take (28).

Summary text

Fluoride is a mineral found in nature, and is artificially added to

toothpaste and water to prevent dental decay. The adding of
fluoride to drinking water, and the use of fluoride in toothpaste, is
now widely recommended by national and international health
organisations. In a study at the school of dental science at the
University of Melbourne, Australian Army recruits were examined
for levels of caries, using technologies such as bitewing
radiography and orthopantomography. It was found that having a
lifetime exposure to fluoridated water led to a 23% reduction in
caries experience, compared to those without such exposure.
Interestingly, females had a slightly higher rate of caries
experience than males.
Controversy has always surrounded the subject of water
fluoridation, and in Australia, not / almost all cities have
fluoridated water. But in the areas that do have fluoridation, the
rate of dental decay is significantly lower. One of the major issues
is the risk of fluorosis. This is a condition where the teeth develop
fine, pearly-white mottling, flecking or lines on the surface of the
teeth, due to excess exposure to fluoride. This staining, difficult to
see with the naked eye, occurs while the teeth are developing, and
is prevented by the careful use of fluoride in water and toothpaste.
In a city water supply, the level of fluoride in the water should be
definitely less than 1.5 ppm, above which level fluorosis can occur.
And children should not use full strength fluoride toothpaste if the
water is fluoridated, and should not take fluoride supplements.